Chronic obstruction pulmonary disorders and treatment options
Chronic Obstruction Disorder disease (COPD) is one the most prevalent cause of morbidity across the globe. It is a curable and partially reversible problem which is manifested by an obstruction in air flow and impaired health status. The patients who have frequent attacks of COPD have worst condition along with acute episodes of symptom exacerbation. The objective of the treatment is to avoid the symptoms through controlling it by including the lung functioning and health status. COPD is linked with abnormal inflammatory response of the lungs to noxious gases or particles. Patients below the age of 35 are at lower risk of COPD and its susceptibility increases when a person comes in a contact with the causative inhalational agents with sufficient capability of triggering the condition. Approximately 90% of cases are associated with smoking. Several environmental determinants such as second-hand smoke and genetic factors also play a significant role in the development of COPD. The Empyema linked to Alpha-Antitrypsin deficiency is the best-known COPD, which is induced by genetic factors. Screening of COPD patients is conducted through spirometry tests where the practitioners analyze the obstruction in the inflammatory airways of the patients. Often pulmonary function based testing are prescribed to the patients (Littner).
The treatment of COPD includes inhaled medications, bronchodilators, anti-inflammatory agents, and corticosteroids. Inhaled medication includes β2-agonists corticosteroids and anticholinergic are the keystones of COPD pharmacotherapy. Apart from therapeutic agents, an education based treatment strategy is also helpful; that may include smoking cessation, pulmonary rehabilitation, and oxygen therapy. For the mild COPD patients short-acting bronchodilators are prescribed whose effect lasts for 3-6 hours. Long-acting bronchodilators can lower the intensity of exacerbations (Littner).
Causes of Respiratory/Metabolic Acidosis and Respiratory/Metabolic Alkalosis
Respiratory Acidosis is a condition when lungs fail to eliminate the carbon dioxide in sufficient quantity that is generated inside the body. Excessive carbon dioxide impacts the pH of blood and builds an acidic environment in the body. There are various reasons of Respiratory acidosis, and one of the main reasons is the decrease in respiratory rate and air movement due to COPD, pneumonia, and asthma. The other main causes are severe obesity, acute pulmonary edema, scoliosis, sedative overdose and weakness in chest muscles.
The cause of metabolic acidosis is a condition when the pH of the body goes down below 7.35. In this condition, the hydrogen ions exceed in the body fluids. Firstly this condition is registered by the buffers, but if it cannot be compensated the respiratory system starts regulating the body fluid pH. This stimulation of respiratory centre causes hyperventilation. Metabolic acidosis occurs when respiratory as well as the renal system cannot maintain the acidity or pH of the body fluids.
Respiratory alkalosis is a condition when carbon dioxide levels drop too low causing the pH of the blood to become alkaline. This condition is the just reverse of respiratory acidosis. The main cause of respiratory alkalosis is hyperventilation or over breathing that mostly occurs during an anxiety state. The other causes of respiratory alkalosis include COPD, drug intake, asthma, infection, heart attack and pulmonary embolism.
Metabolic alkalosis is a reverse condition of metabolic alkalosis which increases the pH of body fluids above the level of 7.40. The pH increase is accompanied by serum bicarbonate concentration and loss of hydrogen ions (H+). The main cause of metabolic alkalosis is the hypoventilation due to blockage of the respiratory centre located in the medulla. This condition occurs when kidney or renal system stops excreting the bicarbonate level and balance the pH levels of body (Marino and Sutin; Frazer and Stewart 195; Blakeley 81-86).
Causes and symptoms of liver disease
Malabsorption
Malabsorption is a syndrome that includes multiple disorders of intestines when intestines are not able to sufficiently absorb the certain nutrients into the blood stream. This syndrome obstructs the absorption of micronutrients such as vitamins and minerals and macronutrients including carbohydrates, proteins, and fats. The primary cause of malabsorption syndrome is an obstruction in the intestinal tract that halts the absorption of fluids and nutrients. This condition may be developed due to any intrinsic disease, inflammation and any injury to the internal lining of the intestines. Often insufficient production of essential enzymes also causes this condition. Prolonged antibiotic use, chronic pancreatic, lactase deficiency, any parasitic invasion, radiation therapy as well as any birth defects are other causative factors (Friedman and Keeffe).
Metabolic disorders
Metabolic syndrome is a collection of risk factors that increases the risk of cardiovascular problems, coronary heart diseases, and certain health problems. Most of the metabolic disorders are asymptomatic. The indicative symptom of metabolic disorders is associated with obesity and large waist circumference. This condition is also associated with insulin resistance because the metabolic disorders mostly develop when blood sugar content is very high that shows symptoms of diabetes such as thirst, frequent urination, blurred vision, and fatigue. The rest factors of metabolic syndrome increases with age, obesity, diabetic conditions, cardiovascular problems, polycystic ovarian syndrome, gallstones and non-alcoholic fatty liver disease (Friedman and Keeffe).
Jaundice
Jaundice is a liver disease that causes discoloration of mucous membrane, skin and white portions of the eyes due to the increased blood levels of bilirubin. It is an underlying process of disease which is caused by abnormal production of bilirubin. The Pre-hepatic jaundice is caused by the early destruction of red blood cells that increase the bilirubin. Malaria, spherocytosis, thalassemia and autoimmune disorders cause this condition. Hepatic jaundice is caused by improper metabolisms and excretion of bilirubin by the liver that may be caused by hepatitis, cirrhosis and cancerous conditions. Post-hepatic jaundice is caused by abnormal excretion of bilirubin from liver into the intestine as bile (Friedman and Keeffe).
Comparing Respiratory Acidosis and Alkalosis vs. Metabolic Acidosis and Metabolic Alkalosis
The normal pH value of human body ranges from 7.35 to 7.40. Any disturbance to these pH levels causes acidosis or alkalosis. When the condition goes below the range, it is called acidosis and when the level goes up the alkalosis. The pH range in acidosis is similar for metabolic as well as respiratory acidosis. Similarly happens in the case of respiratory as well as metabolic alkalosis. Acidosis impacts the central nervous system, developing the conditions of depression while the alkalosis causes the hyperexcitability of the nervous system. Respiratory acidosis or alkalosis is caused by abnormalities of respiratory system while metabolic acidosis or alkalosis is caused by several other conditions along with abnormal respiratory functions. Respiratory alkalosis is caused by hyperventilation of the lungs which is generated due to the metabolic acidosis while trying to eliminate the excessive carbon dioxide along with hydrogen ions to keep the body pH within the range. On the contrary, Respiratory acidosis is caused by hypoventilation. In the metabolic acidosis if the kidneys are functional they excrete hydrogen ions at a higher rate as well as increase the reabsorption of bicarbonate ions. Excessive carbon dioxide reacts with water and produces carbonic acid. If this condition lasts for few hours, the kidneys reduce the rate of hydrogen ions to maintain the body pH and induce reverse alkalosis (Marino and Sutin; Frazer and Stewart 195).
Works Cited
Blakeley, Sara. "Clinical Metabolic Acidosis and Alkalosis." Renal Failure and Replacement
Therapies. Springer London, 2008. 81-86.
Frazer, S. C., and C. P. Stewart. "Acidosis and alkalosis: a modern view."Journal of clinical
pathology 12.3 (1959): 195.
Friedman, Lawrence S., and Emmet B. Keeffe. Handbook of liver disease. Elsevier Health
Sciences, 2011.
Marino, Paul L., and Kenneth M. Sutin. The ICU book. Vol. 2. Baltimore: Williams & Wilkins,
1998.
